What can I do about pregnancy insomnia?

Insomnia is a common sleep problem among adults.

While insomnia can affect anyone, it's normal to have some trouble sleeping during pregnancy. Insomnia affects 1 out of 4 pregnant women during the first trimester, and nearly 2 out of 3 pregnant women by the third trimester. 

Symptoms of insomnia may include:

• Trouble falling asleep
• Trouble staying asleep
• Being awake for much of the night
• Feeling as if you haven't slept at all
• Waking up too early

As a result, you may get too little sleep or have poor quality sleep.

In the first trimester of pregnancy, a woman’s body undergoes many changes that may affect sleep. Increasing levels of the hormone progesterone during early pregnancy can break up a pregnant woman's sleep cycle. Morning sickness and breast tenderness can also disrupt sleep.

It is common for sleep quality to decline with the physical discomfort as pregnancy progresses to the third trimester. Symptoms that can affect sleep include increased heart rate, troublesome heartburn, leg cramps and frequent urination at night. Hormonal changes during pregnancy and the potential anticipation and anxiety about being a new mother can also lead to sleep problems.

Poor sleep has been associated with some negative outcomes for pregnant women and their newborn. Among the health problems that have been linked to sleep problems during pregnancy are high blood pressure, preeclampsia,  gestational diabetes, and depression. Studies show that severe sleep problems may increase the risk of unplanned cesarean section, prolonged labor and prematurity. More research is needed to know exactly how pregnancy insomnia can impact these outcomes.

While it’s common for many pregnant women to experience insomnia, it’s important to talk to your healthcare provider about sleep problems if your symptoms are disrupting your life. Your healthcare provider may ask you about your sleep history and habits, take your medical history, conduct an examination and order tests to rule out other medical problems. Your healthcare provider may also recommend a sleep study.

Improving sleep habits may help reduce insomnia. Solutions may include adjustments to sleeping positions, going to bed only when tired, reducing liquid intake before bed to minimize nighttime bathroom breaks, and avoiding naps and caffeine close to bedtime. Mindfulness and relaxation strategies have been shown to be helpful in improving quality of sleep during pregnancy. Because certain medications and herbal remedies may pose a risk to the developing fetus, pregnant women should always consult with their healthcare provider before taking any medication or herbal remedies to help with sleep.

Insomnia is not a sign of pregnancy. Insomnia is a common sleep complaint among many adults, affecting millions of men and women of all ages. 

Getting quality sleep during pregnancy is important for both mother and infant. Sleep is an essential part of prenatal care. Be sure to talk with your healthcare provider if you're experiencing sleep problems so that you can work together to find solutions and get a better night's sleep.

Clinically reviewed and updated by Nora Laberee, October 2022.